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Prevention and Risks of

Infectious Diseases

Presentation by

- Paige Meadows

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Contents

Shift of Healthcare

Role of the CNA in Infection Prevention

Most Common Infections in the Elderly

Urinary Tract Infections

Respiratory Tract Infections

Skin Infections

Gastro Infections

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The Shift of Healthcare

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The burden disease has on the economy is reduced, while the individuals length and quality of life is increased. (1)

Prevention policies, rather than disease treatments, are far more cost effective andcan reduce healthcare costs overall. (2)

A study showed that the cost of treating hospital acquired infections was ten billion dollars a year.

To treat a single UTI in a nursing home, the cost is 600$. It is increased to 2800$ should the infection become septic.

The Focus of healthcare is shifting from the treatmentof diseases, to disease prevention.

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Infection Controland

The CNA

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It is easy for a CNA to carry bacteria from room to room without realizing it.

It is imperative that the CNA maintain good hygeine to prevent spreading infection.

Because the CNA has the most interaction with the patients, they shouldbe watching for signs of common infections in their patients.

If a CNA suspects anything is wrong with a patient, they should immediatelyreport it to the nurse.

CNA's have the most contact with residents. They are the eyes of the nursing staff.

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Common Infections in

The Elderly

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Urinary Tract Infections

Influenza

Pneumonia

Gastroenteritis/Clostridium Difficile

MRSA/CRE

Scabies

Infections acquired within healthcare facilities are known as “Nosocomial Infections”

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Urinary Tract Infections

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UTI's can lead to bacteremia, which is much harder to treat. (3)

Risk is increased with residents who have catheters, especially with the use of leg bags.

Signs of a UTI can include dysuria, fever, hematuria, suprapubic pain, and an increase in frequency. Some patients may also become confused, and showan altered mental status.

UTI's can be prevented by keeping patients hydrated, wiping from front to back in females,change briefs regularly, and proper catheter care. (6)

Urinary tract infections are the most common typesof infections in nursing homes

Bacteremia provides a means for local infections to travel to distant organs

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Respiratory Tract Infections

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Because elderly patients have weakened immune systems, respiratory tract infections are common in nursing homes.

Pneumonia and the flu are the most common types of respiratory infections. (5)

Pneumonia is the leading cause of mortality in long term care patients, and the common flu is also dangerous for the elderly.

Because the flu is very contagious, it can easily spread around a small nursing home.

Because the elderly cannot clear bacteria from their lungs as easily as they used to, pneumonia occurs more often. Patients who have COPD, feeding tubes, and poor oral health are also at an increased risk for catching pneumonia.

Some signs of pneumonia may be fever, and many have an increased cough. They may also show an altered mental status, and an increase in breathing.

Signs of influenza include fever, chills, headache, and a cough. The mortality ratein nursing homes for the flu is estimated to be around 10%.

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Preventing Respiratory Infections

It is important that healthcare professionals wash their hands thoroughly when dealing with patients that may have the flu or pneumonia. (6)

Elevating the patients head will allow them to breath better, and make it easier forthem to cough up bacteria, as well as decreasing the risk of aspiration. This should alwaysbe done in bedridden patients after eating, including after a tube feeding.

Vaccinations have been proven to be effective in preventing the flu in the elderly. (6)

It is recommended that staff also get vaccinated.

Because weight problems can also lead to breathing issues, encourage patientsto eat healthy to help maintain a healthy weight.

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X-Ray of an Obese PatientVs.

Patient With a Healthy Weight

Weight can lead to breathing problems,especially in elderly patients.

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Skin Infections

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Pressure ulcers occur in roughly 20% of patients, and these can easily becomeinfected. They can also increase the risk of mortality. (6)

Should an ulcer get infected, the infection can run very deep, some going all the way to the bone. These require a lot of attention, and take a long timeto heal completely.

Pressure ulcers are easily preventable. Repositioning a patient every two hoursis effective, as well as skin barrier creams. Good diet and nutrition will make itless likely for an ulcer to form. A sore can form in several hours, but takes severalweeks, or months, to treat.

The CNA should watch out for signs of breakdown on all residents, especially those that cannot get out of bed. This can be redness, open sores, and pain in a specific spot. If aCNA notices any signs of breakdown, they should immediately report it to the nurse.

Elderly patients are not very mobile, so pressure ulcersare a serious issue in nursing homes

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Progression of a pressure ulcer, and a stage 3 ulcer.

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Gastro Infections

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Infections of the gastric tract can be disabling in the elderly

Gastroenteritis is the most common gastro infection in nursing homes, as well as C. Diff. (6)

Both of these can be recognized by frequent diarrhea, that is more than the patientnormally has.

Vomitting is also a symptom of gastroenteritis.

These can be viral, and spread very quickly around a facility, and sometimes leadto the resident being transfered to a hospital.

It is important for workers to remember to always wash their hands before and afterdealing with these patients.

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References

http://www.cdc.gov/HAI/settings/ltc_settings.html

http://www.jstor.org/stable/10.1086/667743

http://www.thedoctorwillseeyounow.com/content/infections/art2748.html?getPage=2

http://www.frost.com/prod/servlet/press-release.pag?docid=272751750http://www.surgeongeneral.gov/initiatives/prevention/strategy/appendix1.pdf

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2754265/

http://www.frost.com/prod/servlet/press-release.pag?docid=272751750

http://www.spinal-injury.net/spinal-injury-network/images/progression-pressure-sore.jpg

http://dccdn.de/pictures.doccheck.com/photos/8/a/8b9a1d3682f077237da62dc154764efa_m.jpg

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Remember to wash your hands...

Any Questions?